UYC Cog Testing and Focus Groups

Generic Clearance for Questionnaire Pretesting Research

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0607-0725 can be found here:

Documents and Forms

Document Name Document Type
Form 1 UYC Cog Testing and Focus Groups Form and Instructi
1 Focus Group Protocol Attachment II - Focus Group Protocol.docx Form and Instruction
2 Cognitive Interviewing Protocol Attachment III - Cognitive Interviewing Protocol.docx Form and Instruction
Main Stage OMB Memo_v2.docx OMB Memo IC Document
Attachment I - Recruiting Flyers.docx Recruitment Flyers IC Document
Attachment IV - Consent Form.docx Consent Form IC Document
Attachment V - Telephone Screener.docx Screener IC Document

Information Collection (IC) Details

IC Title:	UYC Cog Testing and Focus Groups	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Focus Group Protocol	Attachment II - Focus Group Protocol.docx		No		Fillable Fileable
Form and Instruction	2	Cognitive Interviewing Protocol	Attachment III - Cognitive Interviewing Protocol.docx		No		Fillable Fileable

Line of Business: General Government

Subfunction: Central Records & Statistical Mgt

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 210	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	210	210
Annual IC Time Burden (Hours)	480	480
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
OMB Memo	Main Stage OMB Memo_v2.docx	05/07/2019
Recruitment Flyers	Attachment I - Recruiting Flyers.docx	03/20/2019
Consent Form	Attachment IV - Consent Form.docx	03/20/2019
Screener	Attachment V - Telephone Screener.docx	03/20/2019

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.